Effect of d‐β‐Hydroxybutyrate‐(R)‐1,3 Butanediol on Appetite Regulation in People with Prediabetes

Abstract

Scope The main aim of the present study is to study the effect of acute ketosis on parameters of appetite regulation in prediabetes. Methods and results This is a randomized controlled trial registered under ClinicalTrials.gov identifier NCT03889210. After an overnight fast, 18 adults with prediabetes are assigned to consume a ketone monoester (d‐β‐hydroxybutyrate‐(R)‐1,3 butanediol) drink and a placebo drink in cross‐over fashion. Blood samples are collected every 30 min, from baseline to 150 min. Paired t test is used to compare the total area under the curve (AUC) for the changes in parameters of appetite regulation (acylated ghrelin, peptide YY [PYY], and hunger) following both drinks. Significant elevation in blood β‐hydroxybutyrate from 0.2 to 3.5 mmol L−1 (p < 0.001) is achieved within 30 min. Acute ketosis does not result in statistically significant differences in the AUCs for ghrelin, PYY, and hunger. Conclusion Acute ketosis consistently does not affect both objective and subjective parameters of appetite regulation in prediabetes.

Effect of Acute Nutritional Ketosis on Circulating Levels of Growth Differentiation Factor 15: Findings from a Cross-Over Randomised Controlled Trial

“…The utility that exogenous ketone supplements may have during weight loss interventions is likely based on their ability to reduce stress markers during exercise and prolong the period of intense activity rather than modulate appetite [ 26 , 27 ]. This is further confirmed by an earlier CETUS study that reported no statistically significant changes in the appetite hormones ghrelin and peptide YY and no statistically significant differences in hunger when comparing the KEBHB group and the placebo group [ 29 ]. Prior to that study, there was a discrepancy in the literature about whether hunger is reduced during acute nutritional ketosis [ 29 , 30 , 31 ].…”

“…This is further confirmed by an earlier CETUS study that reported no statistically significant changes in the appetite hormones ghrelin and peptide YY and no statistically significant differences in hunger when comparing the KEBHB group and the placebo group [ 29 ]. Prior to that study, there was a discrepancy in the literature about whether hunger is reduced during acute nutritional ketosis [ 29 , 30 , 31 ]. The earlier studies that reported on significant changes in appetite after ketone supplement consumption included controls that were isocaloric dextrose solutions and, therefore, contained carbohydrates (unlike the placebo used in the CETUS project) [ 29 ].…”

“…Prior to that study, there was a discrepancy in the literature about whether hunger is reduced during acute nutritional ketosis [ 29 , 30 , 31 ]. The earlier studies that reported on significant changes in appetite after ketone supplement consumption included controls that were isocaloric dextrose solutions and, therefore, contained carbohydrates (unlike the placebo used in the CETUS project) [ 29 ]. The carbohydrates likely caused a reduction in the levels of ghrelin, resulting in the observed effect of appetite modulation [ 29 ].…”

“…The earlier studies that reported on significant changes in appetite after ketone supplement consumption included controls that were isocaloric dextrose solutions and, therefore, contained carbohydrates (unlike the placebo used in the CETUS project) [ 29 ]. The carbohydrates likely caused a reduction in the levels of ghrelin, resulting in the observed effect of appetite modulation [ 29 ]. The present study takes the field further by grouping the participants according to high versus low scores in three eating behaviour categories before looking at the change in levels of GDF-15.…”

Effect of d-β-hydroxybutyrate-(R)-1,3 butanediol on plasma levels of asprosin and leptin: results from a randomised controlled trial

“…This is in line with another CETUS study that showed that both hunger and hormones responsible for appetite regulation (e.g., ghrelin, peptide YY) were not significantly changed during acute ketosis. 39 Given that WAT has distinct metabolic properties based on where and how much of the tissue is deposited in the body 40 and taking into account that the secretomes of visceral fat and subcutaneous fat are distinct, 41,42 we investigated whether the effects of acute nutritional ketosis on asprosin and leptin are influenced by fat phenotypes. We found that leptin levels were not influenced by the VFV/SFV ratio, IHFD, and IPFD.…”